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General NPI Number Information
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NPI Number | 1215895149
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Entity Type | Organization
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Legal Business Name | JOSHUA TREE GATEWAY COMMUNITIES ALLIANCE
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 73475 29 PALMS HWY
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92277-3127
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Country | US
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Telephone | 442-307-2925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92277-0126
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Country | US
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Telephone | 442-307-2925
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERIC A MENENDEZ
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Credential | RN
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Telephone | 442-307-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number |
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License Number State |
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